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Cefazolin does not accelerate gastric emptying in the critically ill.

M Chapman¹, R Fraser, I de Beaux

¹Intensive Care Unit, Royal Adelaide Hospital, North Terrace, SA 5000, Adelaide, Australia. mchapman@mail.rah.sa.gov.au

Intensive Care Medicine

|June 13, 2003

Summary

Intravenous cefazolin did not alter gastric emptying in critically ill patients. Low-dose cefazolin is not recommended as a pro-kinetic agent in this population.

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Area of Science:

Critical Care Medicine
Pharmacology
Gastroenterology

Background:

Gastric emptying is crucial for nutrient delivery in critically ill patients.
Altered gastric motility is common in intensive care unit (ICU) patients.
Cefazolin is an antibiotic sometimes used off-label to promote gastric motility.

Purpose of the Study:

To investigate the impact of intravenous cefazolin on gastric emptying.
To determine if cefazolin affects gastric motility in mechanically ventilated patients.

Main Methods:

A prospective, double-blind, randomized, placebo-controlled, cross-over trial was conducted.
Fourteen critically ill, mechanically ventilated patients underwent gastric emptying measurements using the C-13 octanoic acid breath test.
Patients received either cefazolin or saline, with the study repeated the next day using the alternative treatment.

Main Results:

Twelve patients completed the study; gastric emptying parameters (gastric emptying coefficient and half-emptying time) were analyzed.
Cefazolin administration did not significantly change gastric emptying compared to placebo (t(50) cefazolin: 138±54 min vs. saline: 122±46 min; P=0.32).
No significant difference was observed in the gastric emptying coefficient between cefazolin and saline (cefazolin: 3.27±0.83 vs. saline: 3.55±0.6; P=0.24).

Conclusions:

Intravenous cefazolin does not affect gastric emptying in mechanically ventilated, critically ill patients.
The findings do not support the use of low-dose cefazolin as a pro-kinetic agent in this patient group.
Further research may be needed to explore alternative pro-kinetic strategies for critically ill patients.